Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults

A Narrative Review, Part 2

On behalf of the Underserved Populations in Headache Medicine Special Interest Section of the American Headache Society

Research output: Contribution to journalReview article

Abstract

Objective: To review the challenges and potential solutions in treatment options for quality migraine care in adult patients who are under or uninsured. Background: The Affordable Care Act has improved access to health care for many; however, those who are underserved continue to face treatment disparities and have inadequate access to appropriate migraine management. Methods: This manuscript is the second of a 2-part narrative review which was performed after a series of discussions within the Underserved Populations in Headache Medicine Special Interest Section meetings of the American Headache Society. Literature was reviewed for key concepts underpinning conceptual boundaries and a broad overview of the subject matter. Published guidelines, state-specific Medicaid websites, headache quality measurement sets, literature review, and expert opinion were used to tailor suggested treatment options and therapeutic strategies. In this second part of our narrative review, we explored migraine care strategies and considerations for underserved and vulnerable adult populations with migraine. Results: Although common, migraine remains untreated, particularly among those of low socioeconomic status. Low socioeconomic status may play an important role in the disease progression, prescription of hazardous medications such as opioids, outcomes, and quality of life of patients with migraine and other headache disorders. There are some evidence-based and guideline supported treatment options available at low cost that include prescription medications and supplements, though approved devices are costly. Resources available online and simple nonpharmacological strategies may be particularly useful in the underserved migraine population. Conclusions: We identified and discussed migraine treatment barriers that affect underserved populations in the US and summarized practical, cost-effective strategies to surmount them. However, more research is needed to identify the best cost-effective measures for migraine management in underserved and vulnerable patients who are uninsured or underinsured.

Original languageEnglish (US)
Pages (from-to)633-647
Number of pages15
JournalHeadache
Volume58
Issue number5
DOIs
StatePublished - May 1 2018

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Migraine Disorders
Vulnerable Populations
Costs and Cost Analysis
Social Class
Prescriptions
Headache
Therapeutics
Patient Protection and Affordable Care Act
Guidelines
Migraine without Aura
Headache Disorders
Health Services Accessibility
Quality of Health Care
Medicaid
Expert Testimony
Opioid Analgesics
Disease Progression
Quality of Life
Medicine
Equipment and Supplies

Keywords

  • headache
  • health disparities
  • migraine
  • treatments
  • underinsured
  • underserved
  • uninsured

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

On behalf of the Underserved Populations in Headache Medicine Special Interest Section of the American Headache Society (2018). Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults: A Narrative Review, Part 2. Headache, 58(5), 633-647. https://doi.org/10.1111/head.13321

Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults : A Narrative Review, Part 2. / On behalf of the Underserved Populations in Headache Medicine Special Interest Section of the American Headache Society.

In: Headache, Vol. 58, No. 5, 01.05.2018, p. 633-647.

Research output: Contribution to journalReview article

On behalf of the Underserved Populations in Headache Medicine Special Interest Section of the American Headache Society 2018, 'Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults: A Narrative Review, Part 2', Headache, vol. 58, no. 5, pp. 633-647. https://doi.org/10.1111/head.13321
On behalf of the Underserved Populations in Headache Medicine Special Interest Section of the American Headache Society. Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults: A Narrative Review, Part 2. Headache. 2018 May 1;58(5):633-647. https://doi.org/10.1111/head.13321
On behalf of the Underserved Populations in Headache Medicine Special Interest Section of the American Headache Society. / Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults : A Narrative Review, Part 2. In: Headache. 2018 ; Vol. 58, No. 5. pp. 633-647.
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